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Home My WebLink About6889-zFORM NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office $outhold, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .N.~s .~.u...P.o..in.t. ~ ......... Street Map No. N.a.s.s. ;..P.t.,. Block No ........... Lot No.8~A. .... C..u.t.e.h.o..g~.....~.~.~.; ........ conforms substantially to the Application for Building Permit heretofore filed in this office .......... ~ep.t..~..., 1973.. pursuant to which Building Permit No~Z.... dated dated ...........$ot~t.. ~{.., 1973., was issued, and confoms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued i~°.r.iY.a..t.? .o.n.e...f..a~...ly. d¥ollinl[ with &5dition & privat~ ga~ag® (&pp~oved .............................................. ]M Ap].s) The certificate is issued to C..o~..r.a.d....A~..~..~.s ....... .0j~...e.~. ............................ (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .. N.~L, ............................. UNDERWRITERS CERTIFICATE No. p#tidLtJlg .................................... HOUSE NUMBER .1. Q3?~. ....... Street ...N.a. ~.s.a.u...P.o..ir~..t..R..o~..~ ................... ~om~ ~o. z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING FERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6889 Permission is hereby granted to: ~outhold pursuant to application dated ...........................~.?..~.~........~.. ........... , 19.?..~..., and approved by the Building Inspector. Fee $..t ~.a.~ .......... THE NEW YORK BOARD OF FIRE UNDERWRITERS ak BUREAU OF EL.ECTRIC~ ~- 85 JOHN STREET, NEW YORK, NEW YORK ]0038 ~,,teNovembe~. 13, 197~I ~pp.c,,.o./Vo.o.~t. 639762 .~ · N 193894 THIS CE~IFIES THAT Co.ad A~en8~ Nassau Point R~) e/stde~ C~tohogue~ L.I. · ~.=.~o. ~ovember ~o ~7~ ~dfou~inco~tia~e~itht~r~ui~mentsofthis~rd. DRY~ I ~NACE ~TO~ I ~TU~ A~A~E N~ METER Town Harbor Lane, Southold, L.I. 11971 em~A~Aeea TOWN OF SOUTHOLD · 'z'. -- ~ ~/~t~'~ ,,/,~ BUILDING DEPARTMENT ~L,~-~'/J.,4~ ~- ~,~ 1 TOWN CLERK'S OFFICE~/~ [~ ~,: /~ , ~UTHOLD, N.Y.~ ~'~, ~ ~ ~ ........ Examined ....... ~ ................ , l~ A~li~ati~ ~ ..... ~ ................ Di~pproved a/c ...... ~........_,_....,..~..~...~..~.~ ~,~ ~/ //~ . ~.~ ~ ......................... ............ {Buildin~ I~ ff ~ ~ APPLICATION FOR BUILDING PERMIT ~ ......... iNSTRUCTIONS ~ a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, wit~'" 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Buitding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ali applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ .................................................................................................................................................. Name of owner of premises ......... CZ:~.~'Z~). ....... ,fa~x~'~l~.~ .................................................................................. If applicant is a corporate, signature of duly authorized officer. ........... ................... ~/ (Name and title of corporate officer) ~ 1. Location of land on which proposed work will be done. Map No.: ...... . .~...~...'~. ~:... ~.~..(...~- .."~..../. ......... LotNo(~ I~'' Street and Num~r ~...~/~ ...... ~....~....~..~...~....~~~ Municipali~ / 2. State existing u~ and occupancy of premiss and intended use and occup~cy of propo~d construction: a. Existing u~ and ~cupancy ....... ~~ ....... ~.~ ..................................................... b. Inten~d u~ and occupancy .......... ~.~,-- ........... ~ ........... · ......................................... ~:....~ ................... ~ Nature of work (check which applicable): New Building .~/,~.~[;~..... Addition ...... Alteration ............... Repair ............. · ............ Removal ......................... Demolition ........................ Other Work ..[ ................................. Estimated Cost ....~.. ~.~.. ~ ...~5~.....¢~...' ...~... Fee ~- [ ~ ....~... ........ E...c~. t~ ° ~.s. cri pt.i..°.n. ! .......... ............ ............... i[~'~'~;i~l'~;;'~i'li~;g this ap~li'~atio;~) ............... If dwelling, number of dwelling units ................. Number of dwelling units on each floor ......................................... If garage, number of cars ...... ~.. ...................................................................................................... ~ .......................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ....~. ........... Rear ..... ~....~. ............... Depth ..e~,~...'. ...................... Height ........ Z'.¢[; .............................................. Number of Stories ...x~.. ...................................................................... Dimensions of same structure with alterations or additions: Front ....... ~. ...........Rear ....~.. ............................... Depth ........ ~'~...~. ........................... Height ........ x~.'~. ........................ i. Number of Stories ....L. ................................. 8. Dimensions of entire new construction: Front ....3;~.....~. ....... Rear ..... .'~E~-....~. ......... Depth ~..~ ..... Height ................................................. Number of Stories ......................................................................................... 9. Size of lot: Front ...... ~....4~...~ .................. Rear ......... ~'...0....~ ..................... Depth ..~......-2.......~....~.....-~... ........... 10. Date of Purchase .~',f~x'Z~.O~. .......... Name of Former Owner ....,~.~Z~:/.~-~.... ................................................... 11. Zone or use district in which premises are situated ...~'m~'.-.-.-.-.-.-.-.-~/.~-~'~, ......................................................... 12. Does proposed construction violate any zoning law. ordinance or regulation: ... ~. .. .. . . . .. .-. ......................................... 13. Will lot be regraded --~.~....--.. ................. Will excess fill be removed from premises: [ ] Yes 14. Name of Owner of premises ..~.~.~x~,~'~,~). ......... Z~.~'.~.~.,,~...-~. .................................... ;[;~.~....--~... .................... (Address} (Phone No.) Name of Architect .............................. = ..................................................................................................................... ~ __ ~. _.(_Address) (Phone No.) _ Name of Contractor ..~:;:~.~.,~......~...[~....~ ...................................... ;~.._... ....... ...'~...~,~ ....... (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. ' ' ' cou., ........ X~..~.....~'..~...~'.~.. ........ ~....:.......~..O...~....~...~....~....J..~ ................ being duly sworn, deposes and says that he is the applicant above named. (Name of individual sig~?ng contract) .e the ........ ....................................................................................................................................................... {Contractor, agent, corporate officer, etc.} o( said owner or owners, and is duly authorized to bet(otto or have p~rform~d tha said work and to make and fils this apolication; that all sta~emznt$ ~ontainad in this aoolication are true to ~h~ b~st of his knowledge and I;~l~f:.a~fhat the work will be p~r~ormad in ~be manner act forth in the application f ad therewith. · ............... ............. day . ....... ~ ~ ~ (S~m~ of appli~t)